7 March 2019 The subcutaneous central venous catheter with reservoir is a device used to provide rapid and long-lasting access to the large deep veins. It consists of: A reservoir - this is placed under the skin, usually in the subclavicular region, and has a silicone disc (arrow) where the repeated punctures are carried out; A catheter — this is a flexible tube measuring around 15 cm long, which is attached to the reservoir at one end, while the other is placed into a large vein. Under which circumstances is a subcutaneous central venous catheter with reservoir used? A subcutaneous central venous catheter with reservoir may be used by patients requiring repeated intravenous injections, for example: Administration of drugs; Nutritional support fluids; Chemotherapy; Blood transfusions. It can also be used to collect blood samples for testing. With this device, it is no longer necessary to make repeated peripheral venous punctures. The decision to implant a subcutaneous central venous catheter with reservoir may be made when an intravenous treatment is expected to last for a long time (more than 6 months). On the other hand, a catheter may also be implanted when peripheral venous access does not meet the safety conditions for carrying out a planned treatment, for example: When it is difficult to find veins in good enough condition for injection; When it is expected that the walls of the veins may harden as repeated treatments are carried out. The device can be left in the body for several weeks, months or even years. It is not visible, but it can easily be felt under the skin. How is a subcutaneous central venous catheter with reservoir inserted? The subcutaneous central venous catheter with reservoir is inserted by a general surgeon. The chosen site is anaesthetised (during this local anaesthesia, you may feel some discomfort, but it will not last for long). An incision of around four centimetres is then made. The catheter is introduced and advanced to the desired vein. During the insertion of the catheter, some pressure may be felt on the shoulder of the same side. The free end of the catheter is attached to the reservoir and the skin is stitched on top of it. The stitches are protected by a dressing. After the catheter is placed, an X-ray is performed to confirm it is correctly positioned and that there are no complications. How is the subcutaneous central venous catheter with reservoir used? If necessary, the catheter may be used immediately after it has been inserted. The reservoir is located by palpation and a special needle is used to go through the skin to reach the reservoir, which makes it possible to administer treatment or collect blood. This procedure is not painful , all that is felt is a momentary pressure. At the end of each treatment, a special liquid is placed in the catheter so that it does not become clogged. This is called heparinisation . Immediate care after the insertion of a catheter The stitches are removed around 10 to 12 days after insertion of the catheter. Until the stitches are removed, avoid getting the dressing wet and change it as indicated; If you have persistent fever, respiratory disorders, numbness of the arm on the side of the catheter or if you notice pain, redness or swelling at the site of procedure, seek medical attention. Ongoing care following insertion of a catheter Avoid lifting heavy weights and sudden movements or effort with the arm on the side of the catheter; Avoid tight-fitting clothes, braces, shoulder bags or any objects that could increase compression or local stress; If you notice changes in the colour and temperature or hardening of the area where the catheter was inserted, seek medical attention; If catheter is not used for some time it may be necessary to heparinise it. This article was written with the support of physicians and other clinical professionals from the Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
